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[脑退行性疾病背景下的衰老视网膜]

[The Aging Retina in the Context of Cerebral Neurodegenerative Diseases].

作者信息

Böhm Michael R R, Thanos Solon

机构信息

Klinik für Augenheilkunde, Universitätsklinikum Essen.

Institut für Experimentelle Ophthalmologie, Westfälische Wilhelms-Universität Münster.

出版信息

Klin Monbl Augenheilkd. 2019 May;236(5):682-690. doi: 10.1055/s-0043-105266. Epub 2017 Jun 9.

Abstract

BACKGROUND

Neurodegenerative diseases (ND) consist of divers affections of the central nervous system related to etiology, localization, and of course of the disease. Alzheimer's disease (AD) and related dementias are best investigated together with socioeconomic conditions and play an important role in its high prevalence. This work will present ND diseases in the context of analogous retinal degeneration mechanisms and ophthalmological diseases.

METHODS

Based on epidemiological data, the current neurological bibliography of ND has been considered. Additional ophthalmological data containing age-related retinal diseases were included in a comparative manner. Moreover, our own data dealing with similarities of cellular and molecular biomarkers in the retinal and cerebral aging process were included.

RESULTS

AD is the most important neurological ND disease with increasing prevalence. Age-related macular degeneration (AMD) and glaucoma are the most common retinal diseases with ND background and have an increasing prevalence. Irreversible loss of neurons, together with glial, microglial, extracellular, and vascular reactions are found both in the brain and retina and can show atrophic signs with onsets of plaques (AD), drusen (AMD) or optic degenerations. Alterations of cellular conditions result in irreversible functional impairments. Current therapeutic options preserve only residual function and preventive possibilities are actually missing. Molecular biomarkers have been identified to endorse a better understanding of ND and to provide new therapeutic options.

CONCLUSIONS

Comparison of cerebral AD shows similarities with retinal AMD, and cerebral dementias are comparable with the physiological age-related impairment of visual acuity. Optic degeneration may be similar to cerebral atrophy associated with retroocular compression. Improved understanding of pathogenetic mechanisms of cerebral and retinal diseases may help to establish preventive and therapeutic concepts in the future.

摘要

背景

神经退行性疾病(ND)包括与病因、定位以及疾病进程相关的中枢神经系统的多种病变。阿尔茨海默病(AD)及相关痴呆症最好与社会经济状况一同研究,且在其高患病率中起重要作用。这项工作将在类似视网膜变性机制和眼科疾病的背景下介绍ND疾病。

方法

基于流行病学数据,考虑了当前ND的神经学文献。以比较的方式纳入了包含年龄相关性视网膜疾病的额外眼科数据。此外,还纳入了我们自己关于视网膜和大脑衰老过程中细胞和分子生物标志物相似性的数据。

结果

AD是患病率不断上升的最重要的神经学ND疾病。年龄相关性黄斑变性(AMD)和青光眼是具有ND背景的最常见视网膜疾病,且患病率不断上升。在大脑和视网膜中均发现神经元的不可逆丧失,以及胶质、小胶质、细胞外和血管反应,并且可表现出斑块(AD)、玻璃膜疣(AMD)或视神经变性发作时的萎缩迹象。细胞状况的改变导致不可逆的功能损害。目前的治疗选择仅保留残余功能,而实际上缺乏预防可能性。已确定分子生物标志物以更好地理解ND并提供新的治疗选择。

结论

大脑AD与视网膜AMD的比较显示出相似性,且大脑痴呆症与与年龄相关的生理性视力损害具有可比性。视神经变性可能类似于与眼球后压迫相关的脑萎缩。对大脑和视网膜疾病发病机制的更好理解可能有助于在未来建立预防和治疗概念。

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